People detained under the Mental Health Act dying at three times the rate of those held in prisons

People sectioned under the Mental Health Act are dying at three times the rate of those held in prisons, figures have revealed.

A new report from the Advisory Panel on Deaths in Custody (IAPDC), a government advisory body, has said that deaths in custody remain “far too high” and that those detained under the Mental Health Act (MHA) are most at risk.

The IAPDC analysed deaths in prisons, police custody, immigration detention and under the MHA between 2017 and 2021.

It found that while prisons have the highest number of deaths, with an average of 322 deaths per year, patients detained under the MHA have the highest mortality rate when taking into account the time spent in custody and numbers of people in each setting.

An average of 263 people died while detained under the MHA each year for the past five years, with a spike in 2020 when 363 people died.

An average of 18 people died in police custody each year, the report found, while there was one death a year in an immigration removal centre.

Urgent improvements needed in recording of data

People in custody under the age of 40 have the highest rate of suicide and other unnatural deaths, while men continue to have a higher rate of deaths in all custody settings.

Researchers said that data gaps, especially on deaths under the MHA, mean it is not possible to identify the rate of deaths by race, ethnicity or sex in hospitals and police custody.

The IAPDC has called for urgent improvements to the way data is recorded and published. It reinforced longstanding concern at the lack of independent scrutiny of deaths under the MHA.

Unlike deaths in prisons, police custody, and immigration detention which are independently investigated prior to an inquest, deaths in secure health settings are often investigated by the same trust responsible for the patient’s care.

The IAPDC has called for independent investigation of these deaths to address the significant gap in learning and accountability needed to help prevent future deaths.

Transparency is ‘integral’ to understanding

Lynn Emslie, chair of the IAPDC, called for government action to help keep people safe in custody: “Each death in custody is devastating and has far-reaching impact. When a death does occur, it should raise searching questions for public services and the government about their ability to keep people under their care safe.

“I urge the government and all those involved in the care of people in detention to heed the findings of this report.”

Professor Seena Fazel, the IAPDC member who conducted the statistical analysis with his colleague Dr Amir Sariaslan at the University of Oxford, added: “Our analysis shows that the number and rate of deaths in custody remain high. The availability, accessibility and transparency of high-quality data is integral to our understanding of these deaths to help inform effective interventions.

“Despite the substantially elevated rate of deaths of individuals under the Mental Health Act, data in this area remains poor and inconsistent compared with other custody settings.”

A Department of Health and Social Care spokesperson said: “People detained under the Mental Health Act need urgent treatment for a mental health disorder and are at risk of harm to themselves or others.

“We are committed to improving the safety of patients detained under the Mental Health Act and providing quality care for all patients. We have moved quickly to identify ways we can improve mental health inpatient care including commissioning an independent, rapid review and a separate, national safety investigation into mental health inpatient settings.”